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Kaiser Daily Global Health Policy Report

In The News

Trump Administration Moves To Eliminate Word 'Gender' From U.N. Human Rights Documents, The Guardian Reports

The Guardian: Trump administration wants to remove ‘gender’ from U.N. human rights documents
“The U.S. Mission to the United Nations is seeking to eliminate the word ‘gender’ from U.N. human rights documents, most often replacing it with ‘woman,’… At recent meetings of the U.N.’s Third Committee, which is concerned with ‘social, humanitarian, and cultural’ rights, U.S. diplomats have been pushing for the rewriting of General Assembly policy statements to remove what the administration argues is vague and politically correct language, reflecting what it sees as an ‘ideology’ of treating gender as an individual choice rather than an unchangeable biological fact. … ‘We are seeing this more and more coming up on the Third Committee, and this is going to be a battle in the coming weeks,’ said a U.N. diplomat. The diplomat noted that U.S. policy on the word is not entirely consistent. … The U.S. Mission to the U.N. referred inquiries to the State Department, which did not offer a comment before publication…” (Borger, 10/25).

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Violence In DRC Continues To Hinder Ebola Outbreak Response

The Guardian: Wave of rebel attacks leads to surge in DRC Ebola cases
“A wave of attacks by rebels and militia on health officials fighting the latest Ebola outbreak in Democratic Republic of Congo is leading to a surge in reported cases as the response to the lethal disease weakens…” (Burke, 10/25).

Additional coverage of the DRC Ebola outbreak is available from VOA News and Xinhua News.

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Study Estimates 2014 West African Ebola Outbreak Cost At $53B

Reuters: West Africa’s Ebola outbreak cost $53 billion — study
“An Ebola outbreak that ravaged Sierra Leone, Guinea, and Liberia in 2014 cost economies an estimated $53 billion, according to a study in this month’s Journal of Infectious Diseases. The study aimed to combine the direct economic burden and the indirect social impact to generate a comprehensive cost of the outbreak, which was the worst in the world. … The total is far higher than previous estimates…” (Miles, 10/24).

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World Lung Conference Opens With Calls To Urgently Address TB, Lower Price Of Treatment

Health-e News: TB drug price protests take center stage at World Lung Conference launch
“As the opening ceremony of the 49th Union World Conference on Lung Health kicked off in the Netherlands last night, protesting activists demanded Johnson & Johnson (J&J) slash its price for the blockbuster tuberculosis (TB) drug, bedaquiline…” (Green, 10/25).

Xinhua News: Tuberculosis under spotlight at world conference on lung health
“…The unnecessary millions of deaths each year from TB is a global health emergency and requires urgent action, said José Luis Castro, executive director of the International Union Against Tuberculosis and Lung Disease (The Union), organizer of the conference…” (10/25).

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Afghanistan, Pakistan, Nigeria Hold Key To Polio Eradication, WHO Says On World Day

VOA News: 3 Endemic Countries Hold the Key to a Polio-Free World
“As another World Polio Day comes around, the World Health Organization reports three polio endemic countries — Afghanistan, Pakistan, and Nigeria — hold the key to the global eradication of this crippling disease…” (Schlein, 10/24).

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War, Economic Collapse Place Half Of Yemen's Population At Risk Of Famine

The Guardian: Famine in Yemen could become one of worst in living memory, U.N. says
“Yemen is sliding fast toward what could become one of the worst famines in living memory, the U.N.’s top emergency relief official has warned. The country is in ‘clear and present danger’ of mass deaths from starvation, and as many as 14 million people — half the population — could soon be entirely dependent on aid to survive, the under-secretary general for humanitarian affairs, Mark Lowcock, said…” (Graham-Harrison, 10/24).

IRIN: Famine in Yemen: A primer
“…The truth is that Yemen has been teetering on the edge of famine for much of its more than three and a half years of war, and while food prices have recently shot up thanks to a collapsing currency, this is not the first time humanitarians have rung the alarm bells. … Yemen’s currency has been in freefall since September, causing a spike in food and fuel prices and even further impacting the average Yemeni’s ability to purchase what they need to survive. … But declaring a famine is a technically complicated process…” (Slemrod/Parker, 10/24).

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Dubai Declaration Agreed At World Forum Aims To Boost Funding, Develop Partnerships For More Effective Data

U.N. News: Funding boost for sustainable development data agreed at U.N. conference
“In a declaration agreed at the close of the 2018 U.N. World Data Forum in Dubai on Wednesday, leaders in the field agreed on measures to boost funding for data and statistical analysis, to speed up progress towards the 2030 Sustainable Development Goals. Named the Dubai Declaration, the agreement aims to mobilize domestic and international funds, and activate more effective data partnerships…” (10/24).

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AP Examines How Hospitals Detain Patients Who Cannot Afford Bills In First Of 2-Part Series

Associated Press: AP Investigation: Hospital patients held hostage for cash
“…At Kenyatta National Hospital [in Kenya] and at an astonishing number of other hospitals around the world, if you don’t pay up, you don’t go home. … Dozens of doctors, nurses, health experts, patients, and administrators told the Associated Press of imprisonments in hospitals in at least 30 other countries, including Nigeria and Congo, China and Thailand, Lithuania and Bulgaria, and others in Latin America and the Middle East. The AP investigation built on a report last year by the British think-tank Chatham House; its experts found more than 60 press reports of patient detention in 14 countries in Asia and sub-Saharan Africa…” (Cheng, 10/25).

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More News In Global Health

Devex: Q&A: How to integrate sexual and reproductive health services into broader health agendas (10/24).

Devex: Pregnant women in Nigeria are shunning medical centers. Here’s why. (Adepoju, 10/25).

Devex: Enabling people, transforming lives with assistive products (10/25).

The Guardian: Child malaria deaths dramatically cut by suppository drug, shows Zambia study (Ratcliffe, 10/25).

The Lancet Infectious Diseases: Disappointment from U.N. high-level meeting on tuberculosis (Burki, November 2018).

VOA News: Syria’s Food Production Hits 29-Year Low (Schlein, 10/23).

VOA News: Indonesian Village Bans 3 HIV+ Orphans From School (Andriansyah/Mazrieva, 10/24).

Xinhua News: U.N. agencies vow to step up efforts to contain polio in Somalia (10/25).

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Editorials and Opinions

Investing In Primary Health Care Critical To Stopping Local Disease Outbreaks, Preventing Global Pandemics

The Guardian: As Ebola has shown, the global health system is as strong as its weakest link
Ellen Johnson Sirleaf, former president of Liberia

“…[T]he world’s health system is only as strong as its weakest link. Investing in primary health care is the best way to detect and stop local outbreaks before they become global pandemics. … Countries must learn from each other — and not just in times of crisis. … West Africa still feels the lasting effects of Ebola, while our brothers and sisters in [Democratic Republic of the Congo (DRC)] are working urgently to bring an end to the current outbreak before it spirals out of control. Unless we learn the hard lessons, the global health system will remain like a house without a foundation. Ensuring that everyone, everywhere, has access to essential health services is our best shot at avoiding the all too familiar cycle of health emergencies…” (10/25)

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U.N. HLM On TB Constitutes Missed Opportunity To Accelerate SDG

The Lancet Infectious Diseases: Tuberculosis at the United Nations: a missed chance
Editorial Board

“…The purpose of the [U.N. High-Level Meeting on Tuberculosis] was to provide a platform for high-level leaders to reaffirm their commitment to accelerate efforts towards the Sustainable Development Goal of ending the tuberculosis epidemic by 2030, but the outcome was unsatisfactory. … Looking closely at the final endorsed version of the political declaration on tuberculosis … shows that only two quantifiable short-term objectives are mentioned: commitment to provide diagnosis and treatment with the aim of successfully treating 40 million people with tuberculosis from 2018 to 2022, including 3.5 million children; and provision of preventive treatment for 30 million people by 2022. How these targets will be met, where the money and infrastructural strengthening will come from, and what individual countries will need to do to achieve those goals was not clearly defined. … The reality is that — despite some nice words on paper — a valuable opportunity to galvanize tuberculosis control has been missed” (November 2018).

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Opinion Pieces Discuss Global Efforts Needed To Eradicate Polio

TIME: What Must Be Done to Create a World Without Polio
Barry Rassin, president of Rotary International, and Tedros Adhanom Ghebreyesus, director general of the WHO; both organizations are members of the Global Polio Eradication Initiative

“…[D]elivering vaccines is no simple task. Polio has taken refuge in some of the most complex and dynamic environments in the world. But over time we’ve learned how to deliver health services in the face of extreme adversity, even in areas with almost no infrastructure. … Our [partnership, the Global Polio Eradication Initiative,] has also demonstrated its capacity to operate strategically, despite insecurity. … We have also worked globally to strengthen local health systems and respond to community needs beyond polio vaccination. … These examples illustrate the tenacity of this coalition, which — thanks to committed vaccinators, donors, and advocates around the world — has come so far since making that promise in 1988 to rid the world of polio. We are so close to keeping that promise. We have seen how readily the virus can push back, but we are more committed than ever before” (10/24).

Devex: The biggest threat to a polio-free world? Our own complacency
David Loew, executive vice president of Sanofi and the head of Sanofi Pasteur

“…When the world is polio-free, we must face a foe as powerful as the disease itself: our own complacency. We all need to continue to commit to immunizing children against polio for several decades. … The good news is that there is a reliable way to protect against the deaths and paralysis that polio could otherwise cause in future generations: A vaccine without any live virus can be made part of the series of routine injections that every child already receives. … The global plan is to stop using [oral polio vaccine (OPV)] after polio eradication and use only [inactivated polio vaccine (IPV)] to prevent re-emergence — provided there is enough IPV. … Sanofi Pasteur has been part of the polio eradication program since the beginning but, should there be any future delays or failures, we are unlikely to have the capacity to supply the whole world. … I do support the desire to rely on more manufacturers to produce IPV. Diversification must, though, be planned and — to use the jargon — ‘de-risked.’ … The historic success of ending polio is close and we should make sure that everything is in place to get there…” (10/24).

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Bangladesh's Parliament Should Reject Strict Draft Drug Law, Move Toward More Effective Drug-Control Policy

Project Syndicate: Bangladesh’s Deadly War on Drugs
Naomi Burke-Shyne, executive director of Harm Reduction International

“…[Under the Bangladesh authorities’ draft law submitted to Parliament,] possession of more than five grams of ‘yaba’ — a methamphetamine-based drug targeted by the government’s crackdown — could be punishable by death. … Despite what governments claim, the death penalty for drug offenses does not target kingpins. It is the poor and the most vulnerable who suffer. … Moreover, there is simply no evidence that the death penalty for drug use lowers rates of consumption or trafficking. … Bangladesh’s Parliament still has an opportunity to reject the draft law and move the country toward a more effective drug-control policy. Enacting the death penalty would only exacerbate an already deteriorating human-rights situation. Around the world, countries are recognizing that executions, much less extrajudicial killings, have no effect on the drug trade. Bangladesh must recognize this, too” (10/24).

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From the Global Health Policy Community

U.N. Member States Agree To Astana Declaration To Strengthen Primary Health Care Systems

UNICEF: New global commitment to primary health care for all at Astana conference
“United Nations Member States today unanimously agreed to the Declaration of Astana to strengthen their primary health care systems as an essential step toward achieving universal health coverage. The Declaration of Astana reaffirms the historic 1978 Declaration of Alma-Ata, the first time world leaders committed to primary health care. … UNICEF and WHO will help governments and civil society to act on the Declaration of Astana and encourage them to back the movement. UNICEF and WHO will also support countries in reviewing the implementation of this declaration, in cooperation with other partners” (10/25).

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Public Health Experts Discuss Importance Of Implementing Guidelines, Improving Access To Treatment For MDR-TB

PLOS Blogs’ “Speaking of Medicine”: Inexcusable Excuses: Reluctance to Quickly Improve MDR-TB Treatment
Helena Huerga, clinician and epidemiologist working with Médecins Sans Frontières (MSF)’s Epicentre; Uzma Khan, clinician and public health professional at Interactive Research and Development (IRD); and KJ Seung, clinician and public health professional at Harvard Medical School and Partners In Health (PIH), discuss the importance of implementing the new WHO guidance for treating multidrug-resistant tuberculosis (MDR-TB), writing, “Programs must take up the advice of the WHO and update treatment regimens to take advantage of these new tools and provide the best care possible for their patients. It is time for action (and new drugs), not excuses” (10/24).

PLOS Blogs’ “Speaking of Medicine”: Combating MDR-TB: Bringing a Knife to a Gunfight
Animesh Sinha, physician with Médecins Sans Frontières, discusses the role of bedaquiline and delamanid in treating MDR-TB and stresses the importance of making both drugs widely available, writing, “These drugs are long-awaited reinforcements in a failing battle and should be made available to every physician managing MDR-TB patients; countries and global health actors must meet this challenge” (10/24).

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Global Dispatches Podcast Examines India's Experience Eliminating Polio

U.N. Dispatch’s “Global Dispatches Podcast”: The Inside Story of How India Eliminated Polio
Mark Leon Goldberg, editor of the U.N. Dispatch and host of the Global Dispatches Podcast, writes, “Through interviews and archival material, this special episode of Global Dispatches tells you the story of how, against all odds, India eliminated polio” (10/24).

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From the U.S. Government

USAID Works Toward Preventing Sexual Misconduct, Abuse Within Agency, Development Sector

USAID’s “IMPACTblog”: How USAID Is Working to Prevent Sexual Misconduct and Exploitation
David Moore, USAID’s acting deputy administrator and chair of the agency’s Action Alliance for Preventing Sexual Misconduct, discusses USAID’s zero tolerance policy for sexual misconduct, including the expansion of protections to prevent sexual exploitation and abuse into all of the agency’s humanitarian assistance programs. Moore writes, “Our ultimate goal is a sector-wide culture of respect and inclusion” (10/24).

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